PRURIGO (prurigo; synonym prurigo) — group of the diseases of skin which are characterized by an itch and rashes in the form of papules, urtikariya and papules ovezikul.
Distinguish the nursery a prurigo (see. Strophulus ), Gebra's prurigo, chronic prurigo of adults, knotty prurigo of the Guide and summer prurigo.
Gebra's prurigo begins in the early childhood, usually on the first year of life. The etiology and a pathogeny are studied insufficiently. A certain part is assigned by endointoxications, allergies (house allergens, and also food and medicinal), to endocrine disturbances, bad a dignity. - a gigabyte. to conditions, a hypovitaminosis, etc.
are observed by Patogistologicheski small acanthosis (see), spongiosas (see), hypostasis of a papillary layer of a derma with expansion circulatory and limf, vessels and okolososudisty infiltration from lymphocytes, neutrophils and eosinophils.
In the beginning at children the elements characteristic develop for small tortoiseshells (see) or strophulus (see) which in 2 — 3 gradually are replaced it is lovely the pair, dense and strongly pruritic small knots of light pink or grayish color located preferential on extensor surfaces of extremities it is much less — on a trunk and a face. During the combing small knots become covered by small bloody crusts. Skin of affected areas is gradually condensed, likhenifitsirutsya, gets grayish-brown coloring, becomes dry, rough. Increase peripheral limf, nodes is observed. Patients have no bottom reflex (Pavlov's symptom), neurosises, symptoms of rickets, dystrophy of teeth, anomalies of a structure of a skull, lag in physical development, etc. are noted. The resistant white dermographism, an eosinophilia is characteristic. The current is chronic, improvement is noted in summertime. Quite often P. becomes complicated pyoderma (see).
At treatment recommend sedative and fortifying means (drugs of bromine, a valerian, glycerophosphates, redoxons, B1, PP, etc.), antihistaminic drugs; locally appoint drugs of tar in the form of pastes or ointments, Unna's cream containing 1/3 corticosteroid ointments (Flucinarum, Ftorokortum, Prednisolonum, etc.), heat baths with officinal herbs. Stay in the fresh air is reasonable, heliation (see), sea bathings, and also molochnorastitelny diet, vitamin-rich.
Chronic the prurigo of adults develops at the persons having diseases went. - kish. a path, a liver, kidneys or having the centers hron, infections, napr, tonsillitis, it is also usually connected with endointoxication (see) and an autoallergization of an organism (see. Autoallergy ). On skin there are edematous small knots with a vesicle at top (see. Vesicle ), dense small grayish papules (see), the urtikariya, raschesa which are becoming covered by hemorrhagic crusts. The centers of defeat are localized preferential on extensor surfaces of extremities, buttocks. A current chronic with periodic aggravations. At treatment apply injections of hystoglobulin, sedatives, antihistaminic drugs, and also recommend suggestive therapy, electrosleep (see) and hypnosis (see), acupuncture (see). At ovarian and pituitary and adrenal disturbances carry out corresponding hormonal therapy (see). Locally appoint spirit rubdowns with menthol, carbolic to - that, anaesthesin. Sulphurous and radonic bathtubs, sea bathings, heliation are shown.
Knotty a prurigo of the Guide — the rare kind of P. Nablyudayetsya is more often at women with an unstable nervous system at the age of 30 — 40 years. Communication of a disease with endocrine (ovarian and pituitary and adrenal) frustration, an endointoxication, functional disturbances of various parts of the nervous system is supposed.
Patogistologicheski in epidermis is observed hyperkeratosis (see), acanthosis, granulez (thickening of a granular layer); in a derma — limfogi-stiotsitarny infiltrate, lack of collagenic and elastic fibers, a hyperplasia of fibers. The wedge, a picture is characterized by a pristupoobrazny severe itch and formation of the dense isolated brownish or grayish papules with a diameter up to 0,5 — 1 cm (sometimes it is more), semi-spherical shape, sharply rising over the surface of skin. The surface of papules smooth or warty, is covered with dense horn scales, hemorrhagic crusts. Typical localization — extensor surfaces of extremities. Current chronic. Treatment is same, as at chronic to a prurigo of adults. It is recommended to destroy separate papules by means of electrothermic coagulation (see. Diathermocoagulation ), cryotherapies (see) or to delete in the operational way.
Summer the prurigo (Getchinson's synonym a recurrent photodermatosis) is shown by rashes of papulovesicules on the open body parts (a face, forearms) which underwent solar radiation and is a version photodermatosis (see).
Diagnosis all forms P. establish on the basis a wedge, the picture confirmed in doubtful cases gistol, a research of skin. Differential diagnosis is carried out with neurodermatitis (see), mange (see), a disease of Dyuringa (see. Dyuringa disease ), etc.
Prevention includes elimination of the diseases promoting emergence of the Item.
Bibliography: Berenbeyn B. A. Pruritic dermatosis (neurodermatoses), M., 1971, bibliogr.; Pototsky I. I. and Torsuyev N. A. Skin and venereal diseases, Kiev, 1978; Skrip-kin Yu. K. Neyrodermit (Questions of an etiology, pathogeny and therapy), M., 1967, bibliogr.
S. T. Pavlov, Yu. K. Skripkin.